Course Withdrawal Form

    Please review the withdrawal and refund policies prior to submission and contact studentaccounts@sjcme.edu or finaid@sjcme.edu with questions regarding your specific financial situation.

    Your student support specialist will contact you at the email address or phone number you provide for additional information or counseling.

    Complete this form and click submit.

    * Required Information

  • Your Contact Information

  • First Name:*

    Last Name:*

    Country:*

    Address:*

    City:*

    State/Province:*

    Zip/Postal Code:*

    Primary Phone Number:*
    Format: 555-111-9876

    Alternate Phone Number:
    Format: 555-111-9876

    Time Available:

    Email Address:*


  • Request

  • Is this a course or program withdrawal?*


    If course, which course(s) are you withdrawing from?

    Withdraw Course 1:

    Withdraw Course 2:

    Withdraw Course 3:

    Withdraw Course 4:

    Student Support Specialist:*

    Withdraw reason:*

    Explanation:*




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